Stefanie Brunner1, Lynne Stecher1, Stephanie Ziebarth2, Ina Nehring2, Sheryl L Rifas-Shiman3, Christine Sommer4,5, Hans Hauner6, Rüdiger von Kries2. 1. Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum Rechts der Isar, Technical University of Munich, Uptown Munich Campus D, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany. 2. Division of Epidemiology, Institute of Social Pediatrics and Adolescent Medicine, Ludwig Maximilians University Munich, Munich, Germany. 3. Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA. 4. Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway. 5. Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. 6. Else Kröner-Fresenius-Centre for Nutritional Medicine, Klinikum Rechts der Isar, Technical University of Munich, Uptown Munich Campus D, Georg-Brauchle-Ring 60/62, 80992, Munich, Germany. hans.hauner@tum.de.
Abstract
AIMS/HYPOTHESIS: Excessive gestational weight gain (GWG) may be a risk factor for gestational diabetes mellitus (GDM). We aimed to study the association between excessive GWG (defined according to Institute of Medicine recommendations) prior to GDM screening, and GDM. METHODS: We systematically searched four electronic databases from 1990 until September 2014 for observational studies published in English or German that reported an association between excessive GWG and GDM as the outcome. Random effects meta-analyses were performed to provide a pooled estimate of the OR comparing the risk of GDM in women with and without excessive GWG. RESULTS: A total of eight studies involving 13,748 participants were included. The pooled analysis of unadjusted OR yielded a summary OR of 1.40 (95% CI 1.21, 1.61; p < 0.001) with low between-study heterogeneity (I(2) = 16.7%). A sensitivity analysis based on four studies reporting adjusted effect estimates revealed similar results (OR 1.42; 95% CI 1.20, 1.68; p < 0.001; I(2) = 0%). No evidence was found that the effect of GWG on GDM differs depending on maternal pre-pregnancy BMI category. A funnel plot did not indicate substantial publication bias. CONCLUSIONS/ INTERPRETATION: Avoiding excessive weight gain in pregnancy prior to the GDM screening test may be a potential strategy to reduce GDM risk. META-ANALYSIS REGISTRATION: www.crd.york.ac.uk/PROSPERO CRD42014008802.
AIMS/HYPOTHESIS: Excessive gestational weight gain (GWG) may be a risk factor for gestational diabetes mellitus (GDM). We aimed to study the association between excessive GWG (defined according to Institute of Medicine recommendations) prior to GDM screening, and GDM. METHODS: We systematically searched four electronic databases from 1990 until September 2014 for observational studies published in English or German that reported an association between excessive GWG and GDM as the outcome. Random effects meta-analyses were performed to provide a pooled estimate of the OR comparing the risk of GDM in women with and without excessive GWG. RESULTS: A total of eight studies involving 13,748 participants were included. The pooled analysis of unadjusted OR yielded a summary OR of 1.40 (95% CI 1.21, 1.61; p < 0.001) with low between-study heterogeneity (I(2) = 16.7%). A sensitivity analysis based on four studies reporting adjusted effect estimates revealed similar results (OR 1.42; 95% CI 1.20, 1.68; p < 0.001; I(2) = 0%). No evidence was found that the effect of GWG on GDM differs depending on maternal pre-pregnancy BMI category. A funnel plot did not indicate substantial publication bias. CONCLUSIONS/ INTERPRETATION: Avoiding excessive weight gain in pregnancy prior to the GDM screening test may be a potential strategy to reduce GDM risk. META-ANALYSIS REGISTRATION: www.crd.york.ac.uk/PROSPERO CRD42014008802.
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